Healthcare Provider Details

I. General information

NPI: 1003969924
Provider Name (Legal Business Name): GRAY CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 DEAHL ST
BORGER TX
79007-4707
US

IV. Provider business mailing address

PO BOX 1127
BORGER TX
79008-1127
US

V. Phone/Fax

Practice location:
  • Phone: 806-273-3366
  • Fax: 806-273-2532
Mailing address:
  • Phone: 806-273-3366
  • Fax: 806-273-2532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. KENT D. GRAY
Title or Position: MANAGER
Credential: D.C.
Phone: 806-273-3366